Zafar Ali Choudhry, Muhammad Saleem Iqbal, Muhammad Latif, Kamran Hamid.
Comparison of Direct Trocar versus Veress Needle Insertion in Creation of Pneumoperitoneum in patients Undergoing Laparoscopic Cholecystectomy.
Annals Punjab Med Coll Jan ;13(2):126-9.

Objective: Comparing outcome of Veress Needle (VN) versus Direct Trocar insertion (DTI) for creation of Pneumoperitoneum in laparoscopic Cholecystectomy. Study Design: Randomized Controlled Trial. Settings: Khawaja Muhamamd Safdar Medical College Surgical Department, Faisalabad Medical University Surgical Department, Allama Iqbal Memorial Hospital and Govt.  Sardar Begum Teaching Hospital, Sialkot. Duration: 27-09-2017 to 26-09-2018. Methodology: A total number of 608 patients, having age 30 and 75 years planned for laparoscopic Cholecystectomy were selected. Detailed history, clinical examination & baseline investigations were carried out. Patients were divided into two groups. Group A (DTI), Group B (VN). All trocars and veress needle used were disposable, with a safety shield. Maximum 3 attempts were made and in case of failure open technique were used. The collected data was stored and analyzed in SPSS version 22. Chi-square test was used to compare no. of attempts between the groups. Results: Mean age of patients in present study was 47.99+11.01 years. There were 211 (34.70%) male patients and 297(65.30%) female patients. In DTI group, Pneumoperitoneum was created successfully in first attempt in 278 (91.4%) patients, in 2nd attempt in 20 (6.6%) patients and in 3rd attempt in 6 (2.0%) patients. While in VNI group Pneumoperitoneum was successful in first attempt in 256(84.2%) patient sin 2nd attempt in 38 (12.5%) patients and in 3rd attempt in 10 (3.3%) patients (p-value 0.02). Conclusion: Direct trocar is a safe alternative to veress needle insertion in laparoscopic cholecystectomy. It requires less number of attempts for successful creation of Pneumoperitoneum as compared to the veress needle.

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